Leadership Quality and Risk of Long-term Sickness Absence Among 53,157 Employees of the Danish Workforce.

OBJECTIVE: To examine whether low leadership quality predicts long-term sickness absence (LTSA) in Denmark. METHODS: Using Cox models, we estimated the association between exposure to low leadership quality and onset of register based LTSA (>/=6 weeks) during 12-months follow-up among 53,157 employees without previous LTSA. RESULTS: During 51,155 person-years, we identified 2,270 cases of LTSA. Low leadership quality predicted LTSA with a dose-response pattern after adjustment for confounders. The hazard ratio (HR) of LTSA in the lowest compared to the highest quartile of leadership quality was 1.61 (95% CI: 1.43-1.82). Further, change from high to low leadership quality over time predicted risk of LTSA (HR = 1.42, 95% CI: 1.02-1.97) compared to persistent high leadership quality. CONCLUSIONS: Exposure to low leadership quality is a risk factor of LTSA in the Danish workforce.